Credentialing

Credentialing

Credentialing is an important step for any physician who is new to Kids Health First. The process for completing the physician membership application packet is very lengthy and dependent upon receipt from you of the detailed information required by Kids Health First and the insurance companies.

If all documents are in order, it will typically take Kids Health First approximately 45 to 60 days to credential a new physician. It will generally take an additional 60-90 days for a Payor to input the new physician into its system. Again, all documents need to be complete at submission.

Please review the physician membership application packet which has all of the documents necessary to complete the physician’s credentialing application.

If your new physician does not have hospital privileges with Children’s Healthcare of Atlanta, please apply for these prior to sending Kids Health First the physician’s credentialing application. The physician must have these privileges in order to complete the Kids Health First credentialing process.

Please be sure to follow all directions noted on each of the applicable forms which are listed below. Any missing information or missing supporting documents can delay the process:

Please note—For CIGNA, a second original copy of the above document is required. The physician must sign and date two copies. The first copy is for Kids Health First. The second copy is for CIGNA.

Required for CIGNA

Required for Aetna

Required for Peach State Medicaid CMO

For Practices that take Medicaid, please be sure to fill out the state Medicaid application for your new physician as soon as possible. For a physician that does not currently have a state of Georgia Medicaid number it can take up to 6 months to get this. The Kids Health First Medicaid Payors will NOT accept any data for your new physician until we can furnish them with this number.

Please note that Kids Health First does not credential mid-level providers but can assist with adding them to the payor contracts.


For more information or questions, please contact Toni Williams, Revenue Cycle Operations Manager, at twilliams@khfirst.com, 770-333-0033, ext. 216, or 678-545-5500.